African Journal of Pharmacy and Pharmacology Vol. 6(3), pp.

221-224, 22 January, 2012

Available online at http://www.academicjournals.org/AJPP
DOI: 10.5897/AJPP11.860
ISSN 1996-0816 ©2012 Academic Journals

Full Length Research Paper

An evaluation of Pakistani pharmacy students’

knowledge of herbal medicines in Pakistan
G. MURTAZA1*, S. AZHAR1, S. NOREEN2, S. A. KHAN1, A. KHAN3, B. NASIR4, A. MUMTAZ3, M. ZAMAN5 and M. S.
U. REHMAN5
1
Department of Pharmaceutical Sciences, COMSATS Institute of Information Technology, Abbottabad, Pakistan.
2
Department of Chemistry, University of Sargodha, Sargodha, Pakistan.
3
Department of Chemistry, COMSATS Institute of Information Technology, Abbottabad, Pakistan.
4
Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
5
Department of Pharmacy, University of Lahore, Lahore, Pakistan.
Accepted 5 January, 2011

The objective of study was to evaluate the knowledge of students on herbal medicines in Pakistan. To
evaluate knowledge among the students, a questionnaire based study about herbal medicines was
designed. Mean age of responding students was 22 years, some of them had used herbal medicines in
past and some were still using. Majority of the students were interested in the information related to
herbal medicines. The response of students about herbal medicines was good. But they had a little
knowledge about their adverse effects. But some of them had no idea about the interaction between
herbal medicines and allopathic medicines. Herbal medicine information should take a part of pharmacy
curriculum for undergraduate students. Education program should be started amongst the pharmacists
about the safety of herbal medicines in Pakistan.

Keywords: Herbs, students, perception, survey, Pakistan.

INTRODUCTION

Herbal medicines are also called botanical medicines and
these are used for medicinal and therapeutic purposes.
Herb is a plant or a part of plant used for its medicinal,
aromatic or cookery qualities. Herbal medicine treatment
is also used as phytotherapy and this name was given by
French scientist, Henry Leclerc. In ancient times, herbs
were also used as a therapy for mankind. But as we see,
the history of herbal medicines was used by all the
cultures (Fakeye et al., 2001). If it is to talk about the
discovery of herbal medicines, various observations are
made; (1) many of the herbs are obtained from wild
animals and (2) some herbs are used in some conditions
and other herbs are not used in the same disease. The
interactions of herbs also cause potentiation of some
diseases (Hegnauer, 1978). If a disease such as hypert-
ension is treated with herbal medicines, the plant extract
containing possibly large number of medicine is used.
*Corresponding author. E-mail: gmdogar356@gmail.com. Tel:
+923142082826. Fax: +92992383441.
From this, it can be concluded that they have a
synergistic effect and this synergy of herbs also affects in
vivo processes, such as absorption, metabolism and
excretion (Kemper and Festschrift, 1975).
In the 20th century, most of the pharmacopoeia are
derived which are written by the people having
knowledge of endogenous herbs. A lot of herbs are used
still for treating various diseases; the reason behind this
is that most of the people believe that they have less
toxic effects and more synergic effects (Naidu and
Wilkinson, 2005). Indeed, there is at least one active
agent which has a plant origin in 25% prescription in US.
Example of atropine derived from atropine belladonna
has a muscrinic effect, widely and acceptably used by the
people. By using this method of the herbal therapy, the
public also takes interest in this therapy. The use of
herbal medicines worldwide is also due to their low cost
and synergistic effect.
In Pakistan, there is no useful origin of information for
herbal medicines. The objective of this study was to
elaborate university students’ awareness about herbal
medicines.
222 Afr. J. Pharm. Pharmacol.
Table 1. Data showing correct answers regarding herbal
medicines.
University/Institute Success percentage (%)
WIL 74.27
CIIT 81.93
PIPS 65.14
HU 75.98
METHODOLOGY
Study design
The investigation of knowledge about herbal medications among
undergraduate science students was completed through cross-
sectional study design. The purpose of this survey was to establish
knowledge among these science students and to check their
current knowledge regarding herbal medicines. Data were
assembled by questionnaires and through face-to-face interviews.
The survey was assessed by the combined efforts of faculty
members and students of COMSATS Institute of Information
Technology (CIIT), Abbottabad. In this study, both male and female
participants were included, such that, the number of respondents
from CIIT were 1832, out of which 877 were females and remaining
were male (955). Number of participants from Hazara University
was 837, out of which 287 are female and 550 are male students.
Total strength of students from Pakistan Institute of Professional
Studies (PIPS) was 93 including 60 male and 33 female students.
The strength of responding students from Women Institute of
Learning (WIL) was 68 (all were female. This study was approved
by the Board of Advanced Studies and Research (Local Ethical
Committee), COMSATS Institute of Information Technology,
Abbottabad, Pakistan. A two stage random sampling methodology
was employed. During stage 1, students were selected through
simple random sampling and stage 2 covered the assortment of
students from other locations. The students were briefed, the aim of
the study and then obtained sanction from the students to
participate in this study. The filling of questionnaires was conducted
in the presence of an expert researcher for assisting the
respondents, if required.
Study location
Four institutes [COMSATS Institute of Information Technology
(CIIT), Hazara University (HU), Pakistan Institute of Professional
Studies (PIPS) and Women Institute of Learning (WIL)] were
selected as research-rigorous organizations.
Data collection
This survey was conducted using a structured pre-channeled
questionnaire containing 28 different closed-ended questions.
Every question had four options with one correct answer. The
questionnaire contained questions on demography and students’
knowledge about herbal medications. Twenty queries were about
herbal medicines including introduction, history, general and herbal
drugs, such as, the herbal drug, which causes the contraction of
heart muscles, is called digitalis. It is extracted from the plant,
Foxglove, and can play an important role in treating heart failure
patients. In this survey, introductory data was collected from the
students, such as age, sex and level of education in various
categories of students. To check the knowledge about herbal
medicines, questions were asked from the students about
interaction, side effects and synergic effects of various medicines.
Demographic information consists of age, sex and year of their
studentship. The respondents were also permitted to add any
additional information regarding their knowledge about herbal
medicines. After pilot-testing for content and design on 25 students,
necessary modifications were made in the questionnaire. The
students were not allowed to use any helping material and
discussion among each other. A complete examination environment
for 15 to 20 min was provided to the students so that their personal
knowledge about herbal medicines could be assessed (Hasan et
al., 2000).
Data analysis
Data was analyzed using Statistical Package for Social Sciences
(SPSS) version 13.0 using one way analysis of variance (ANOVA)
with confidence interval of 95%.
RESULTS
Total number of participating students was 2830.
Students who replied correctly (success rate) were
74.22%, out of which 48.88% were males and 25.34%
were female students. Out of 837 students of HU, 636
students could correctly reply the questions with a mean
percentage of 75.98%. Out of 1832 students of CIIT,
1501 (in which pharmacy students were 341 and re-
maining were from engineering, business administration
and earth science departments) correctly answered the
questions with a success rate of 81.93%. Out of 68
students of WIL, 51 correctly responded to the questions,
so the success rate was 74.27%. Out of 93 students of
PIPS, 56 answered the questions correctly at a success
rate of 65.14% (Table 1).
About one third of the pharmacy students (34.02%)
respond that they are well trained in the field of herbal
medicines, while 38.2% of the students reply that they
are not yet well trained about herbal medicines. From
this, it can be concluded that there is need of teaching
and training for more knowledge on herbal medicines at
university level studentship. 2% students also expressed
that the pharmacists cannot be expert in the field of
herbal medicines. About 95% of pharmacy students
showed that the pharmacists have more knowledge
about the herbal drugs as compared to the students of
other professions. Most students (44%) believed
phytotherapy is safe. Regarding safe and synergistic
effects of the herbal medicines, 16.22% students believe
that herbal medicines show these effects and 2% of
students show no confidence about the efficacy and
safety of herbal medicines. While 12% of students realize
that they have no idea about synergistic effects, safety
and efficacy of herbal medicines.
Regarding possible interactions or adverse effects of
herbal medicines, 68.7% of the students believe that
interactions may occur with herbal medicine interaction,
while 15.2% of students realize that there is no
interaction with herbal medicines, and about 15.11% of
students have no idea about such interactions.

DISCUSSION
Many eastern and western countries use herbal
medicines for treatment, because it is cheap and
accessible. Present results depict that pharmacy students
have good knowledge about herbal drugs than the
students of other disciplines, because of their experience
in the field of pharmacy. In questionnaire, some
questions were found easy for students of 1st profess-
sional year, but some were difficult for them. As question
1 is about definition of the herbal medicines, which is so
simple that each and every student easily answered it.
The students of pharmacy profession believed that they
would gain a lot of knowledge about herbal medicines
from the course work of bachelor degree of pharmacy.
Present curriculum of pharmacy (in the subject of
Pharmacognosy) has enough coverage of herbal
medicines. The herbal medicine training, which is a part
of pharmacy degree, is objected by most of the
pharmacists and is considered insufficient. It reveals that
the pharmacists want to know more about herbal
medicines just like they know about allopathic medicines
(Annual report of the Eastern Mediterranean Region,
2005). This training, which is a part of bachelor degree of
pharmacy, was however rated as being inadequate by
majority of the pharmacy students. This seems that the
worldwide trend as pharmacists would want to know
much about herbal medicines as they do about allopathic
agents.
Concerned to other questions related to the knowledge
of herbal drugs, students of higher classes took a lead as
they have covered most part of the syllabus and know
more about herbal drugs than their juniors, for example,
as they were asked about the herbal drug “digitalis”, for
what purpose it is used? And its correct answer is “it is
used in heart failure” because it has effect on the
contraction of heart muscles.
According to a previous study, fresh pharmacy
graduates had more knowledge about herbal medicines
than older graduates and generally pharmacy teachers
have more knowledge than the students. Pharmacists
also believe that due to their training in herbal medicines,
they are best liable to prescribe the herbal drugs to the
patient than the physicians (Chang et al., 1999).
In the part of questions regarding herbal history, results
are out of order. It means that only few of the students
know basics history of herbal drugs. When they were
asked about the scientist who first introduced the term of
“phytotherapy” and correct answer is “Henri Leclerc”, only
10% of the students could correctly answer this question.
This shows their interest that how much they consult
books and to what extent they are keen to study history
of herbal medicines. This shows that students have kept
themselves limited to the lecture notes as provided by the
teachers to prepare for examination as a guideline. In
nature, books are the friends and tell the solution of every
question. With the help of this research, one more thing
which is personally observed is that study does not mean
Murtaza et al. 223
only to get good marks, rather to get useful knowledge
that could benefit us in our daily life. In Pakistan, it is a
common practice of students to get good grade points in
examinations with the help of notes, and it should be
discouraged.
Coming back to this study topic that is about herbal
medicines and their role in daily life, students were asked
about general methods used for the extraction,
purification and manufacturing of the crude drugs. Most
(84%) of the students answered this question correctly.
Our survey reveals that lectures should be delivered
about herbal medicines to the students as a part of their
syllabus. It is also observed that pharmacists have
greater knowledge about herbal medicines than other
professional who have no idea about herbal medicines
(Suchard et al., 2006; Chang et al., 2000; Murtaza et al.,
2011). As a result, it can be suggested that if topics
related to herbal medicines could be included in
pharmacy curriculum for undergraduate students training,
students’ knowledge can be improved in this context.
Conclusion
The use of herbs among pharmacy and other students is
widely spread but they have insufficient information about
the side effects, interaction and synergistic effect of
herbal medicines. Pharmacy students know more about
the use of herbal medicines. The increased use of herbal
medicines necessitates getting more education and
updated information regarding herbal medicines. All this
can be possible by involving herbal medicines in the
curriculum for students. The pharmaceutical associations
can play a vital role in introducing herbal drug to be
prescribed by pharmacists. So, these pharmacists can
properly educate people by giving them knowledge about
phytopharmaceuticals.
REFERENCES
Annual report of the Eastern Mediterranean Region (2005). WHO, pp.
45-49.
Chang ZA, Kennedy DT, Holdford DA, Small RE (1999). Pharmacists’
knowledge and attitude towards herbal medicines. J. Pharm. Sci., 12:
11-17.
Chang ZG, Kennedy D, Holdford D, Small R (2000). Pharmacists
knowledge and attitudes toward herbal medicine. Ann.
Pharmacother, 34(6): 710-715.
Fakeye TO, Abu T, Adebisi O (2001). A survey of of the use of herbs
among patients attending secondary health care facilities in
Southwestern Nigeria. J. Herb. Pharmacother., 28: 45-50.
Hasan MY, Das M, Behjat S (2000). Alternative medicine and the
medical profession: views of medical students and general
practioners. East Mediterr. Health J., 6: 25-33.
Hegnauer R (1978). Herbal plants as medicines. Planta Med., 34: 1-25.
Kemper FH, Festschrift FA (1975). Dr Wilmar Schvub encyclopedia.
Karlsruhe Publishers, Berlin, Germany, pp. 192-197.
Murtaza G, Abbasi SI, Irum H, Jadoon MK, Hussain I (2011).
Assessment of breast cancer literacy among female students in a
Pakistani university. Wspolczesna Onkol., 15(6): 381-384.
Naidu S, Wilkinson JM (2005). Attitudes of Australian pharmacists
toward complementary and alternative medicines. Ann
224 Afr. J. Pharm. Pharmacol.

Pharmacother., 39: 1456-1461

Suchard JR, Suchard MA, Steinfeldt JL (2006). Physician knowledge of
herbal toxicities and adverse herb-drug interactions. Pharm. Pract.,
34: 121-124.